Prevalence and acquisition of MRSA amongst patients admitted to a tertiary-care hospital in brazil

AUTOR(ES)

Santos, Helena Barreto dos

DATA DE PUBLICAÇÃO

2011

RESUMO

Background: There are few studies in Brazil that address baseline prevalence of MRSA colonization and associated risk factors at hospital admission, or the incidence of nosocomial colonization. We report a prospective study in a tertiary-care, university-affiliated hospital to implement a new MRSA control policy at the institution. Methods: A cohort of randomly selected patients admitted to emergency and clinical wards at our hospital was followed until discharge. Nasal swabs were taken for identification of MRSA-colonized patients and detection of SCCmecA in positive cultures, at admission and weekly thereafter. Multivariate analysis using a log-binomial analysis was used to identify risk factors for colonization. Results: After screening 297 adult patients and 176 pediatric patients, the prevalence of MRSA at admission was 6.1% (95%CI, 3.6% to 9.4%), in the adult population and 2.3% (95%CI, 0.6% to 5.7%), for children. From multivariate analysis, the risk factors associated with colonization in adults were: age above 60 years (P = 0.019) and hospitalization in the previous year (P = 0.022). Incidence analysis was performed in 276 MRSA-negative patients (175 adults and 101 children). Acquisition rate was 5.5/1,000 patient-days for adults (95%CI, 3.4 to 8.5/1,000 patients-days), and 1.1/1,000 patient-days for children (95%CI, 0.1 to 4.0/1,000 patients-days). Conclusions: The identification of MRSA carriers is a step towards establishing a control policy for MRSA, and helps to identify measures needed to reduce colonization pressure and to decrease the high acquisition rate in hospitalized patients.

ASSUNTO(S)

brasil idoso adulto idoso de 80 anos ou mais epidemiologia portador sadio criança pré-escolar infecção hospitalar feminino hospitais universitários estatística e dados numéricos humanos incidência lactante masculino staphylococcus aureus resistente à meticilina isolamento e purificação meia-idade análise multivariada prevalência estudos prospectivos analise de regressao fatores de risco infeccoes estafilicocicas

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